Environmental Toxicity Flashcards
What binds heme iron in hemoglobin 200-fold more strongly than O2
Carbon monoxide
Carboxyhemoglobin shifts dissociation curve for oxyhemoglobin _____.
Left, this impedes the dissociation of O2
What what level (percent) of COHb concentration will you have collapse and convulsions?
50-60%
At what level of COHb concentration will you have death?
70%
At what levels of COHb concentrations will you have severe headache, vomiting, visual disturbance?
30-40%
How does hyperbaric oxygen therapy help with carbon monoxide posioning?
Reduces the half life of COHb from 5 hours to 20 minutes
Protect against long term brain injury
What is found in fruits and leaves of the Prunus species (almonds, apricoits, cherries, peaches, and plums)? and some other plants, apples, cassava, elderberry, hydrangea and others?
Cyanide
What are some industrial uses for cyanide?
Gold and silver ore extraction, stainless steel manufacturing, and petroleum refining
What does cyanide form complexes with?
Cation-containing enzymes
What is the most significant rapid and irreversible binding of cyanide to?
Ferric ion (Fe 3+) contained in mitochondrial cytochrome oxidase
When cyanide inhibits mitochondrial cytochrome oxidase the generation of what stops?
ATP, this leads to tissue anoxia
With cyanide poisoning there is an accumulation of ____ acid due to the cessation of aerobic metabolism.
Lactic
What are some initial symptoms of cyanide poisoning?
Flushing Tachycardia Tachypnea Headache Dizziness N/V
What can happen with worsening toxicity w/ cyanide poisoning?
Loss of consciousness Coma Hemodynamic comprimise Arrythmias Seizures Apnea Cardiac arrest Death
Elevated oxygen where is often present in cyanide poisoning?
Venous blood
There is a serum lactate of > or = to _____ in cyanide poisoning.
10 mmol/ L
What are the three steps to treat cyanide poisoning?
Decontamination
Stabilization
Antidote
What is the antidote for cyanide poisoning?
Hydroxocobalamin
Each molecule of Hydroxocobalamin binds one cyanide ion forming _________.
cyanocobalamin
What type poisoning is at highest risk for young children and causes a disruption of the BBB?
Lead
What does lead encephalopathy result in?
Lethargy, vomiting, irritability, and dizziness
can progress to altered mental status, coma, and death
Lead toxicity interferes w/ the synthesis of ______
hemoglobin
What are three chelators used to treat lead toxicity?
EDTA
DImercarprol (BAL)
Succimer
What 2 chelators binds lead, arsenic, and mercury?
Dimercaprol (BAL)
Succimer
What are 2 antidotes for iron toxicity?
Defuroxamine, Deferasirox
What are 2 antidotes for Copper, used in Wilson’s disease.
Penicillamine
Trientine
What are three common pesticides?
Parathion
Malathion
Diazinon
What do pesticides do?
Inhibit acetylcholinesterase, producing acute muscarinic and nicotinic toxicity
What are 2 treatments for pesticide toxicity?
Atropine and Pralidoxime
Which pesticide treatment is a muscarinic antagonist?
Atropine
What is the number for poison control?
1-800-222-1222
What drug classes in toxic levels can lead to mydriasis?
Adrengeric agonists
Anticholinergics
What drug classes in toxic levels can lead to miosis?
Sympatholytics
Cholinergics
With what type poisonings will the patient have an almond smell?
Cyanide
Amygdalin
Apricot pits
With what type poisoning will the patient have a fishy odor?
Zinc/aluminum phosphide
What what poisonings will a patient have an acetone smell?
Ketosis
ethanol
isopropyl alcohol
salicylates
